I agree with Seth Haber, MD (December 2007, page 8), that academic chairs should be eligible for fellowship in the College, despite their lack of board certification. I take issue, however, with his assertion that these individuals are, of necessity, “... unaware of the benefits of CAP membership.” It does not require membership to receive CAP TODAY and the Archives of Pathology & Laboratory Medicine, both of which are superb sources of information about the CAP in particular and pathology practice in general. Thus, the chairs who actually seek to be “aware” (Dr. Haber’s term) certainly can be even if they are not CAP fellows.
Dr. Haber’s letter is silent in regard to the deeper problem: Most medical centers and hospitals require board certification before granting clinical practice privileges. At these institutions, therefore, non-certified academic chairs may be unable to participate in the clinical work of the department for which they are responsible. This is an anomaly rarely encountered in any other specialty. I have never met an academic chair of surgery, pediatrics, or ophthalmology, for example, who is unable to have clinical privileges, and do some clinical work, in the department he or she runs. Quite possibly there are one or two such persons in the U.S., but the number in pathology seems far larger. I realize that many pathology chairs are busy with research and administration, but that is not unique to pathology; it is also true in surgery, pediatrics, ophthalmology, etc.
In summary, while I would join Dr. Haber in welcoming academic chairs as fellows of the College, the vastly more important question is why so many departments are headed by individuals who cannot perform the clinical services within their specialty. What kind of message does this convey to students considering various specialty options? Dr. Haber hopes the chairs will “... proselytize and recruit for us ...,” but is this a realistic expectation when the chair is unable to provide patient-care services?
(I am retired and not aware of any conflicts of interest in this matter.)
Dwight K. Oxley, MD
Having read Drs. Wendy Gunther and Stephen Cina’s dismissal of the forensic techniques used in “CSI” (December 2007, page 64), I am left wondering just what it is that a forensic pathologist can say with certainty. Perhaps it would be to society’s benefit to have the “CSI” team arrive for every potentially sinister demise. At least the conclusions would be swift (one hour), the lawyer’s reimbursement meter turned off, and everyone could get back to their routine tout de suite.
Kevin Monroe, MD